Pandey M, Mathew A, Abraham E K, Ahamed I M, Nair K M
Department of Surgical Oncology, Regional Cancer Centre, Kerala, India.
Eur J Surg Oncol. 1998 Aug;24(4):303-7. doi: 10.1016/s0748-7983(98)80011-5.
To investigate malignant mucosal melanoma (MMM), a rare disease and one which has, till lately, remained unrecognized. Incidence of MMM ranges from 2 to 10% in various series.
We retrospectively reviewed the cases of malignant melanoma treated at the Regional Cancer Centre, Trivandrum, India, over a period of 15 years.
A total of 163 cases of melanoma were identified, of which 21 had a lesion in mucosal sites. There were eight cases of upper aero-digestive tract (UADT) melanoma, seven cases of rectal melanoma, five cases with lesions in the vagina and one case with a lesion in the urethra. The mean age of the patients was 52.8 years; mean age of presentation in urogenital and anorectal lesions was similar to overall mean age, while this was lower (47.5 years) for UADT lesions. Almost half of the patients presented with ulcer or nodule with or without pigmentation. Pain was present in three-quarters and vaginal bleeding was present in all cases of vaginal lesions. Almost one-third of the patients failed locally while another third developed distant metastasis during the follow-up period. A 2-year disease-free survival rate of 13.2% (95% CI: 2.2-34.1) was observed, which dropped to 6.6% (95% CI: 0.4-25.7) after 3 years. Survival appeared a little better in UADT melanoma compared to urogenital and anorectal melanoma; however, the difference was not statistically significant.
Malignant mucosal melanoma seems to have an aggressive biological behaviour with a high incidence of local failure and metastasis.
研究恶性黏膜黑色素瘤（MMM），这是一种罕见疾病，直到最近才被认识到。在不同系列研究中，MMM的发病率为2%至10%。
我们回顾性分析了印度特里凡得琅地区癌症中心15年间治疗的恶性黑色素瘤病例。
共确诊163例黑色素瘤病例，其中21例病变位于黏膜部位。有8例上消化道（UADT）黑色素瘤、7例直肠黑色素瘤、5例阴道病变和1例尿道病变。患者的平均年龄为52.8岁；泌尿生殖系统和肛肠病变患者的平均发病年龄与总体平均年龄相似，而UADT病变患者的平均发病年龄较低（47.5岁）。几乎一半的患者表现为溃疡或结节，伴有或不伴有色素沉着。四分之三的患者有疼痛症状，所有阴道病变患者均有阴道出血症状。在随访期间，近三分之一的患者出现局部复发，另有三分之一发生远处转移。观察到2年无病生存率为13.2%（95%CI：2.2 - 34.1），3年后降至6.6%（95%CI：0.4 - 25.7）。与泌尿生殖系统和肛肠黑色素瘤相比，UADT黑色素瘤患者的生存率似乎略高；然而，差异无统计学意义。
恶性黏膜黑色素瘤似乎具有侵袭性生物学行为，局部复发和转移的发生率较高。
